Individual
BONITA J DRAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3950 3RD ST N, ST PETERSBURG, FL 33703-6123
(727) 821-0612
(727) 822-5507
Mailing address
3950 3RD ST N, ST PETERSBURG, FL 33703-6123
(727) 821-0612
(727) 822-5507
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
15815
FL
Other
Enumeration date
09/11/2006
Last updated
07/08/2007
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